Shasta Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D10646 Issued in OR

Legal business name

SHASTA FAMILY DENTAL

Practice address

2504 Shasta Way
Klamath Falls, OR 97601-4356

Phone

(541) 884-5474

Fax

(541) 882-1461

NPI assigned

Aug 15, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mindy Ann Brown, DMDNPI 1255561882

Title

President

Phone

(541) 884-5474

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mindy Ann Brown, DMD

  • General Practice Dentistry
  • Klamath Falls, OR
  • NPI 1255561882
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1427574136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 SHASTA WAY",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976014356",
            "telephone_number": "541-884-5474",
            "fax_number": "541-882-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 SHASTA WAY",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976014356",
            "telephone_number": "541-884-5474",
            "fax_number": "541-882-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHASTA FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MINDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-884-5474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D10646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ketzia Magdalena Jeanne Shafer, THW
• Russell Stephen Shapiro, PMHNP
• Sharon Melnick, MD, PC
• Christopher Grant Sharp
• Shasta Eyecare Associates, LLC
• Shasta View Speech Center, LLC
• Michael Leroy Shatto Jr., DC
• Mikayla Kristen Marie Shave
• Monica Shaw
• Julie Sheasby

• Dental Clinic/Center in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.